tion. Drinking excessive amounts of alcohol, particularly on an empty stomach or if you have liver problems, can also increase the risk of lactic acidosis. Your doctor will monitor you for this side effect, but symptoms that might indicate its development include rapid and/or deep breathing and non-specific symptoms such as feeling weak, sick or generally unwell, vomiting, abdominal pain, or unusual muscle pains or discomfort. You should stop taking this medicine and consult your doctor if you experience any of these.
Your kidney function should be monitored regularly while you are taking this medicine. Your doctor will usually want to check your kidney function once or twice a year, or more frequently if you are elderly or have any existing kidney problems.
Your doctor will ask you to stop taking this medicine temporarily if you are going to have a certain type of X-ray involving an injection of iodinated dye (contrast agent). Tell your doctor that you are taking metformin if you are due to have this type of X-ray. You should not start taking this medicine again until 48 hours after the X-ray, and only after your kidney function has been tested and found to be normal.
Consult your doctor about your diabetes treatment if you are due to have surgery under a general anaesthetic. In these situations blood sugar is normally controlled by insulin, so your doctor may ask you to stop taking this medicine 48 hours before surgery.
The shells of Glucophage SR tablets may pass through your gut undigested and be visible in your faeces. This is normal.
Not to be used in
Diabetic keto-acidosis.
Diabetic pre-coma (due to ketoacidosis in severe and inadequately treated diabetes).
People with decreased kidney function or kidney failure.
People with decreased liver function.
Dehydration.
People with severe infections or sepsis.
People with reduced blood flow to vital internal organs (shock).
People with conditions that cause breathing to be ineffective, ie to not effectively oxygenate the blood or remove carbon dioxide from the lungs (respiratory failure).
Heart failure.
People who have recently had a heart attack.
Alcohol intoxication.
Alcoholism.
Children under ten years of age.
This medicine should not be used if you are allergic to one orany of its ingredients. Please inform your doctor or pharmacist if you havepreviously experienced such anallergy. If you feel you haveexperienced an allergic reaction, stop using this medicine and inform yourdoctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy orbreastfeeding. However, other medicines may be safely used in pregnancy orbreastfeeding providing the benefits to the mother outweigh the risks to theunborn baby. Always inform your doctor if you are pregnant or planning apregnancy, before using any medicine.
The manufacturer recommends that this medicine is not used during pregnancy. If you get pregnant while taking this medicine, or are planning a pregnancy, you should seek medical advice from your doctor. Control of diabetes mellitus in pregnancy is usually achieved using insulin, because this provides a more stable control of blood sugar. However, metformin may be used either on its own, or in combination with insulin, for women with pre-existing diabetes or pregnancy diabetes. This is a recommendation from the National Institute for Clinical Excellence (NICE) 2008 guidance on treating diabetes in pregnancy, which stat
